Radyoterapi Almış Nazofarenks Kanserli Hastalarda Pd-L1, Pd-1 Ve Ebv Ekspresyonunun Sağkalım Üzerine Etkisinin Araştırılması
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Baş boyun skuamöz hücreli karsinomu (BBSHK) dâhil birçok malignitede PD-L1
ekpresyonu bildirilmiştir. Ancak BBSHK çalışmalarında genellikle farklı doğası gereği
nazofarenks kanseri (NFK) tanılı hastalar dâhil edilmemiştir. Bu sebeple biz NFK tanılı
hastalarda Programlanmış ölüm ligandı 1 (PD-L1), Programlı hücre ölümü 1 (PD-1) ve
Epstein-Barr virus (EBV) eksresyonunun sağkalım üzerine etkisini incelemeyi amaçladık.
Yöntem: Bu tek merkezli, retrospektif çalışmaya Ocak 2010 - Mart 2022 tarihleri arasında
küratif radyoterapi almış metastatik olmayan NFK tanılı hasta dahil edildi. PD-L1, PD-1 ve
EBV verileri immünohistokimyasal boyanma sonucu elde edildi. Tümör proporsiyon skoru
(TPS) ve Kombine pozitif skor (CPS) skorları hesaplandı. Verilerin değerlendirilmesinde
bağımsız örneklem t testi, ki kare testi, bağımlı örneklem t testi, tekrarlı ölçümler varyans
analizi, ROC analizi, Kaplan Meier analizi ve Cox regresyon analizinden yararlanıldı.
Anlamlılık için p<0,05 kabul edildi.
Bulgular: Çalışmaya dâhil edilen 60 hastanın %74,1’i EBV negatifti. 29’u PD-L1≥1, 30’u
CPS ≥1 ve 36’sında TPS ≥43 olarak saptandı. TPS değeri ≥43 olanlarda (Total sağkalım)
GS, (Progresyonsuz sağkalım) PFS ve (Metastazsız sağkalım) MFS ortalaması TPS değeri
<43 olanlara göre daha yüksekti (p<0,05). TPS≥43 olanlarda tam cevap oranı TPS<43
olanlara göre tedaviye yanıt cevap daha yüksekti (p<0,05). PD-L1 grupları (<1, ≥1) ve CPS
grupları (<1, ≥1) arasında tümör volümü (NF GTV (cm3)) ortalaması bakımından
istatistiksel olarak anlamlı derecede bir farklılık bulunmakta idi (p<0,05). PD-L1≥1 olan
grup PD-L1<1’e göre ve CPS≥1 olan grup CPS<1’e göre tümör volümü daha yüksek
saptanmış idi (p<0,05).
Sonuç: Metastatik olmayan NFK’de TPS skoru ile tedavi yanıtı öngörülüp adjuvan
tedaviler planlanabilir. Ancak klinik pratiğe geçebilmesi için geniş katılımlı prospektif
çalışmalara ihtiyaç duyulmaktadır.
Objective: Programmed death-ligand 1 (PD-L1) is reported to be highly expressed in various tumour types including head neck squamous cell carcinoma (HNSCC). However most of the HNSCC studies were excluded patients with nasopharyngeal carcinoma (NPC). For this reason, we aimed to investigate Programmed death-ligand 1 (PD-L1), Programmed cell death -1 (PD-1) and Epstein-Barr virus (EBV) expressions and affect on survival in patients diagnosed with NPC. Method: Patients diagnosed with non metastatic NPC treated with definitive radiation therapy between January 2010 and March 2022 were included in this single centre, retrospective study. PD-L1, PD-1 and EBV data were obtained as a result of immunohistochemical staining. Tumor proportion score (TPS) and Combined positive score (CPS) scores were calculated. Independent sample t test, chi square test, dependent sample t test, repeated measures analysis of variance, ROC analysis, Kaplan Meier analysis and Cox regression analysis were used to evaluate the data. P<0.05 was accepted for significance. Results: 74.1% of the 60 patients included in the study were EBV negative. 29 patients had PD-L1≥1, 30 had CPS ≥1, and 36 had TPS ≥43. The mean overall survival (OS), progression free survival ( PFS) and metastasis free survival (MFS) in patients with TPS value ≥43 are higher than in those with TPS value <43 (p<0.05). The complete response rate in patients with TPS≥43 is higher than in those with TPS<43 (p<0.05). There is a statistically significant difference in mean tumor volume (NF GTV (cm3)) between PD-L1 groups (<1, ≥1) and CPS groups (<1, ≥1) (p<0.05). Tumor volume was found to be higher in the PD-L1≥1 group compared to PD-L1<1 and in the CPS≥1 group compared to CPS<1 (p<0.05). Conclusion: In non-metastatic NPC, treatment response can be predicted with TPS score and adjuvan treatments can be planned. However, prospective studies with large participation are needed before it can be implemented into clinical practice.
Objective: Programmed death-ligand 1 (PD-L1) is reported to be highly expressed in various tumour types including head neck squamous cell carcinoma (HNSCC). However most of the HNSCC studies were excluded patients with nasopharyngeal carcinoma (NPC). For this reason, we aimed to investigate Programmed death-ligand 1 (PD-L1), Programmed cell death -1 (PD-1) and Epstein-Barr virus (EBV) expressions and affect on survival in patients diagnosed with NPC. Method: Patients diagnosed with non metastatic NPC treated with definitive radiation therapy between January 2010 and March 2022 were included in this single centre, retrospective study. PD-L1, PD-1 and EBV data were obtained as a result of immunohistochemical staining. Tumor proportion score (TPS) and Combined positive score (CPS) scores were calculated. Independent sample t test, chi square test, dependent sample t test, repeated measures analysis of variance, ROC analysis, Kaplan Meier analysis and Cox regression analysis were used to evaluate the data. P<0.05 was accepted for significance. Results: 74.1% of the 60 patients included in the study were EBV negative. 29 patients had PD-L1≥1, 30 had CPS ≥1, and 36 had TPS ≥43. The mean overall survival (OS), progression free survival ( PFS) and metastasis free survival (MFS) in patients with TPS value ≥43 are higher than in those with TPS value <43 (p<0.05). The complete response rate in patients with TPS≥43 is higher than in those with TPS<43 (p<0.05). There is a statistically significant difference in mean tumor volume (NF GTV (cm3)) between PD-L1 groups (<1, ≥1) and CPS groups (<1, ≥1) (p<0.05). Tumor volume was found to be higher in the PD-L1≥1 group compared to PD-L1<1 and in the CPS≥1 group compared to CPS<1 (p<0.05). Conclusion: In non-metastatic NPC, treatment response can be predicted with TPS score and adjuvan treatments can be planned. However, prospective studies with large participation are needed before it can be implemented into clinical practice.
Açıklama
Anahtar Kelimeler
PD-L1, CPS, TPS, Nazofarenks kanseri, Nasopharyngeal carcinoma
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yılmaz, T. (2024). Radyoterapi Almış Nazofarenks Kanserli Hastalarda Pd-L1, Pd-1 Ve Ebv Ekspresyonunun Sağkalım Üzerine Etkisinin Araştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
